OBJECTIVES:

To investigate drug utilization and drug-related costs of intravitreal injected anti-VEGF drugs in ophthalmology hospital setting, 2013 to 2015

METHODS:

An observational cohort study based on secondary data from hospital pharmacy databases was performed. Patients with intravitreal anti-VEGFs for: wet age-related macular degeneration, diabetic macular edema, macular edema secondary to retinal vein occlusion, choroidal neovascularization secondary to pathologic myopia in the period 2013 to 2015 were included. Anti VEGF drugs reimbursed by the national healthcare system were ranibizumab and aflibercept.

RESULTS:

During 2013-2015, in San Raffaele hospital 2,117 patients started anti-VEGF therapies. Median duration of follow-up for these patients was 224 days (0-1448). Majority of patients was female and mean age was higher for age-related maculopathy (74,9± 9,6). During follow up 138 patients changed medication. The 1,979 that have not changed it were followed for 12 months. A total of 2,279 eyes were treated. There was high prevalence of patients with single administration of drug, mainly in the pathologic myopia group. Patients treated on both eyes were most in diabetic maculopathy (39%); a large amount of patients treated bilaterally received a more intensive treatment on the higher-severity eye. Of the 1,979 patient-years examined, more than half of the spending on drugs (3.3Mil €) was absorbed by age-related macular degeneration, due to the higher prevalence and to the greater mean number of injection.

CONCLUSIONS:

Our study pointed out in Real World environment the followings: a high prevalence of patients who had a single administration of anti VEGF; a suboptimal adherence as compared with drug prescribing information; most of the drug expense was absorbed by age-related maculopathy; a difference in prevalence between the various diseases in terms of patients treated on the second eye; a difference in treatment intensity between the two eyes in cases of patients treated bilaterally.